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Chronic obstructive pulmonary disease - Management
What else might it be?

  • The differential diagnosis of chronic obstructive pulmonary disease (COPD) includes any condition that presents with breathlessness and/or cough. For example:
    • Asthma — consider if the person has a family history, has other atopic diseases or nocturnal or variable symptoms, is a non-smoker, or experienced onset of symptoms at younger than 35 years of age. For more information, see Distinguishing COPD and asthma and the CKS topic on Asthma.
    • Bronchiectasis — clinical features include copious sputum, frequent chest infections, a history of childhood pneumonia, and coarse lung crepitations.
    • Congestive cardiac failure — clinical features include breathlessness when lying flat, a history of ischaemic heart disease, and fine lung crepitations. See the CKS topic on Heart failure - chronic.
    • Lung cancer — consider if the person has haemoptysis, weight loss, or hoarseness. See the CKS topic on Lung cancer - suspected.
    • Interstitial lung disease (asbestosis, pneumoconiosis, fibrosing alveolitis, sarcoidosis) — clinical features include dry cough and fine crepitations.
    • Bronchopulmonary dysplasia — consider in a young adult with recurrent chest infections.
    • Anaemia. See the CKS topics on Anaemia - iron deficiency and Anaemia - B12 and folate deficiency.
    • Obstructive sleep apnoea. See the CKS topic on Sleep apnoea.
    • Tuberculosis. See the CKS topic on Tuberculosis.
  • These conditions may be present in addition to COPD.
  • For detailed information on the differential diagnosis of people with cough or breathlessness, see the CKS topics on Cough and Breathlessness.

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